5703985
| Question | Answer |
| Unit 4- Psychopathology. Phobias Part A- | Clinical characteristics of phobias. Issues surrounding the classification and diagnosis of phobias, including reliability and validity. |
| Psychopathology is a branch of psychology concerned with the study of abnormal behaviour-their origins, developments and manifestation. | A mental disorder is defined in the ICD-10 as 'a clinically recognisable set of symptoms for behaviours associated in the most cases with stress and with intereference with personal functions. social deviance or conflict alone without personal dysfunction shouldnt be included'. DSM-V 'a clinically significant or behavioural or psychological syndrome/pattern that occurs in an individual that's associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom'. |
| A phobia is the most common type of anxiety disorder-we all have things with make us feel anxious or fearful when we encounter them. When the fear becomes excessive and unreasonable is it a phobia. 'An uncontrollable, irrational and persistent fear of an object, activity or situation which creates an overwhelming urge to avoid it'. A panic attack is a feeling of intense fear with physiological symptoms such as rapid breathing, increased heart rate or dizziness. The suffered has a feeling of impending doom and fears dying or losing control. A panic attack occurs without warning, reaches a peak in about 10 minutes and gradually subsides. | Specific phobias; Specific phobias involve fear of specific objects or situations e.g. arachnophobia and claustrophobia. Clinical characteristics of specific phobias; 1) marked and persistent fear that's excessive/unreasonable triggered by the presence/anticipation of specific object or situation. 2) exposure of phobic stimulus provokes an immediate anxiety response-panic attack. 3) the phobic situation is avoided or endured with intense anxiety/distress. 4) avoidance or distress of the feared situation interferes significantly with the person's routine. 5) the anxiety isnt accounted by another mental disorder and must last for 6 months for all ages. 6) the person recognises the fear is excessive/unreasonable. |
| Social phobias; An excessive fear of a particular social situation e.g. eating in restaurants or public speaking. It's not the fear of the situation per se but rather the possibility of embarrassment/humiliation in front of other people. it interferes significantly with the persons working and/or social life- begins in late childhood and can continue with adulthood. Clinical characteristics; 1) marked and persistent fear of one or more situations when the individual will be exposed to unfamiliar people or scrutiny of other people. 2) exposure to feared social situations produces a higher level of anxiety. 3) feared situations avoided or responded to with great anxiety. 4) phobic reactions interfere significantly with the individuals working or social life 5) anxiety, panic attacks or avoidance are not better accounted by another mental disorder and must last 6 months. 6)person recognises the fear is excessive or unreasonable. | Agoraphobia; Fear of open or public places especially debilitating and thought to be the most serious of all phobias. Begins early/mid-twenties with series of panic attacks. Clinical characteristics; 1) anxiety about being situations from which escape may be hard or embarrassing in the event of a panic attack. 2) the panic attacks are not due to use of substance 3) the situations are avoided or endured with marked distress or only manageable with the presence of a companion. 4) anxiety, panic attacks or avoidance aren't better accounted by another mental disorder must be at least 6 months. 5) phobic reactions interfere significantly with the individuals working or social life. 6) recurrent and unexpected panic attacks. |
| Ao1-inter-rater reliability; One issue with classification and diagnosis of phobias related to inter-rater reliability as diagnosis depends on the extent to which there's an agreement between different clinicians. For diagnosis to be reliable, the specialists must be consistent in giving similar scores to a person displaying particular symptoms of phobias. High inter-rater reliability indicated every-time measuring tools are used by different specialists-produces the same outcome (same score or diagnosis). E.g. one patient with phobia symptoms is assessed by a group of several clinicians completed, the clinicians split and make their own scores or diagnosis individually. If all them diagnose an individual with phobia, it's said diagnostic test serves as highly reliable tool. Skyre et al assessed inter-rater reliability for diagnosing social phobia and found a higher inter-rater agreement of +72. This finding suggests that the agreement/reliability is high in classifying and diagnosing phobias. | Ao1- test-retest reliability; One issue with classification/diagnosis of phobias related to test-retest reliability (consistency over time) as diagnostic test for phobias is only reliable if the same practitioner makes the same consistent measurements on separate occasions from the same information. Diagnostic test for phobia's said to be reliable if it produces same diagnosis on different occasions. Hiller reported satisfactory to excellent diagnostic agreement in a test-retest study using MDC. This finding suggests that munich diagnosis checklist can be used as a reliable tool for diagnosis. |
| Ao2- supporting evidence for reliability Research supports the idea that reliability of measurements could be medium to high however it is not consistent across studies and time. Kendler et al used face-to-face and telephone interviews to assess individuals with phobias, using test-retest over a month interval period they found a mean agreement of +.46, over 8 years it was even lower at +.30. On the other hand, Picon et al found good test-retest reliability (better than +.80) with a Portuguese version of SPAI over 14 day interval. This suggests that intra-rater reliability can be good in the short-term however lacking in the long-term. | Ao2- Reasons for low reliability. First, test-retest reliability may be due to the poor recall of participants of their fears e.g. people may over-exaggerate their fears when recalling their previous distress. Secondly, the lower inter-rater reliability may be due to different decisions made by interviewers when deciding if the severity of a symptom does or does not exceed clinical threshold for a symptom. This shows that both the recall of the patients and the interpretations of the interviewers/clinicians can hamper the reliability. |
| Ao1- validity- comorbidity. Phobias occur alongside other mental disorders (called co-morbidity). E.g. social phobia can co-exist with depression-this is an important issue for validity. It has been suggested that social phobia can be a predictor of depression and that it not only increases the risk of developing depression but the severity of symptoms too- which has implications for treatment. Soical anxiety disorder often precedes alcohol abuse and about 20% of those treared for alchol related disorders have social phobia- if it goes undetected the risk of relapse is high. When the phobia is treared the alcohol use appears to improve. Research by Kendler found high levels of comorbidity between social phobias, animal phobias and anxiety disorders/depression. This finding shows that these conditions aren't separate entities and their diagnosis category isn't very useful when deciding what treatment is best. | Ao2-supporting evidence for comorbidity; Evidence from research studies support the idea that phobias co-occur with each other in particular anxiety disorders, depression and social phobias. Eysenck reported that up to 66% of patients with one anxiety disorder are also diagnosed with another anxiety disorder. The implication being that a diagnosis should be simply anxiety disorder rather than OCD etc. Moreover, Vasey and Dadds offer support, they recognise that treatment success of anxiety disorder was unrelated to original diagnosis of specific phobia. In conclusion, using the biological approach due to high comorbidity rate there are no need for distinguishing phobias. |
| Ao1- construct validity Construct validity is also used to assess diagnostic questionnaires and interviews. This measures the extent that a test for phobic disorders really measures a target symptom of phobias, by identifying target behaviours and seeing if people scoring high on phobic test also exhibit target behaviour. E.g. patients with social phobia may ten to underestimate their ability to cope in situations (high levels of anxiety) construct validity would be demonstrated if those also underestimated their ability to cope in social situations. This suggests that construct validity is important in classifying and diagnosing phobic disorders.. | Ao1- concurrent validity It measures the extent to which a new measure of phobic symtoms correlated with an existing one. This is an important aspect of concurrent validity as it establishes the value and accuracy of a new measure of phobic symptoms. Herbert et al established the concurrent validity of the social phobia anxiety inventory by giving the test and other standard measurement to 23 social phobic, they found the SPAI correlated well. This findings suggests that concurrent validity is high enough to accurately classify and diagnose social phobias. |
| Ao2-supporting evidence for concurrent and construct; Evidence from research studies support the idea that measuring tools do indeed measure and diagnose phobias as a real distinctive mental disorder. Mattick and Clark showed that their Social Phobia Scale correlated well with other standard measures (+.54 - +.69) which indicated that there are methods of diagnosis that agree and appear to be measuring something real. | Ao2- cultural differences in classification/diagnosis; There are some important cultural differences in phobias in terms of whether or not extreme fear interferes with normal functioning in particular cultural context. For example, a variation on social phobias called TKS is diagnosed in Japan but not in the West. This is an incapacitating fear of offending/harming other people though one's own social awkwardness. It differs from social phobia in that the fear is of doing harm to others, not being embarrassed. This reflects the Japanese norm of pronounced politeness towards others and is described in DSM manual as a culture-bound system. This suggests that phobias are not universal which is accounted for in the manuals making them valid ways of diagnosing phobia. |
Want to create your own Flashcards for free with GoConqr? Learn more.